The History Of Hiv Treatment: Antiretroviral Therapy And More
The first reports of strange illnesses started popping up in New York and California in 1981. Healthy young gay men were sickened with Kaposiâs sarcoma, a cancer usually found in males who were much older. Others were coming down with a rare type of pneumonia.
A year later, the mysterious disease had a name: acquired immune deficiency syndrome, or AIDS. It destroyed the immune system and left the body open to all kinds of infections.
In 1983, scientists discovered the virus that causes AIDS. They later named it human immunodeficiency virus . The race was on for a treatment to stop this deadly disease.
What Are Fusion Inhibitors
A fusion inhibitor blocks an early step in the viral life cycle. Enfuvirtide attaches to the envelope surrounding the virus and prevents it from entering the CD4 cells. This prevents the infection of CD4 cells by HIV. T-20 is the first approved drug in this class. It is given as a twice-daily subcutaneous injection . It is used primarily in individuals who have developed resistance to other classes of drugs in order to create a new potent combination. Like all other antivirals, it is most useful in those taking other active drugs at the same time in order to optimize the chance of getting viral loads to undetectable levels and to prevent the development of drug resistance.
Side Effects Of Antiretroviral Drugs
Side effects of combinations of antiretroviral drugs may be unpleasant and serious. However, doctors can prevent many serious problems by regularly examining the person and doing blood tests. The blood tests can detect side effects before they become serious and enable doctors to change antiretroviral drugs when needed. For most people, doctors can find a combination of drugs with minimal side effects.
Metabolism of fats may be disturbed, probably primarily by protease inhibitors. The following may result:
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Fat accumulates in the abdomen and breasts of women , and it is lost from the face, arms, and legs.
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The body become less sensitive to insulin’s effects
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Blood levels of cholesterol and triglycerides are increased.
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St. John’s wort St. Johns Wort The reddish substance in the flowers of St. Johns wort contains numerous biologically active compounds, including hypericin and hyperforin. People… read more causes the body to process protease inhibitors and non-nucleoside reverse transcriptase inhibitors more quickly and thus makes them less effective.
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What If I Have Another Illness Or A Co
You may have a co-infection or another illness such as cardiovascular disease, HIV-related cancer, chronic kidney disease or HIV-associated neurocognitive impairment.
In these situations your doctor may need to tailor your antiretroviral treatment or treat your other condition before starting your HIV treatment. This will be explained to you by the clinicians looking after you.
What Are The Symptoms Of Hiv
The symptoms of HIV and AIDS vary, depending on the phase of infection.
When you first acquire HIV it may take a month or two before symptoms show and these may last a week or two. Even then these may easily be confused with another type of viral illness, such as the flu, or so mild as not to be noticed initially. Symptoms of an initial acute HIV infection may include:
- Muscle aches and joint pain
- Painful mouth sores
- Swollen lymph glands, mainly on the neck.
The infection is easily spread during this stage.
The next stage of HIV infection is called clinical latent infection. Generally, there are few signs or symptoms during this stage which may last approximately 10 years, although some people may develop persistent swelling of the lymph nodes or more severe disease sooner. HIV persists in the bloodstream and white blood cells.Infections start to become more common as the virus continues to multiply and destroy your immune cells. Signs and symptoms of symptomatic HIV infection include:
- Yeast infection
- Swollen lymph nodes.
If left untreated, HIV usually progresses to AIDS in about 10 years, although some people never develop AIDS despite never having treatment. A person is said to have AIDS when their CD4 count falls below 200 or when they develop certain opportunistic infections or cancers.
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Risks And Side Effects
HIV medicines can sometimes cause side effects. Some side effects happen for a short time. Other side effects can cause long term health problems. Tell your healthcare provider about any side effects you are having. Do not stop taking your medicine without first talking to your healthcare provider. Your healthcare provider may tell you tips to help you cope with the side effects. Your healthcare provider may also tell you to take different medicines.
- This page does not give the specific side effects and warnings for each HIV medicine.
- Talk to your healthcare provider about the side effects and warnings for the medicines you take.
- Check the FDA Web site to find more HIV medicine information.
My Regimen
It is important that you take your HIV medicines just as your healthcare provider tells you. Your medicines may not work if you skip a dose or do not stick to your schedule. Over time, you can get sick if you do not take your medicines as directed. Your HIV may become resistant to your medicines. This means your medicines could stop working and more HIV could build up in your body.
Here are some tips to help you remember when to take your HIV medicines.
- Use a schedule or planner.
- Set the alarm on your watch or phone.
- Use a pillbox to help you organize your pills.
- Ask a friend or family member to help you.
Chart to help you remember when to take your HIV medicine
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IMPORTANT TIP
What Should I Tell My Healthcare Provider Before Taking Biktarvy
- All your health problems. Be sure to tell your healthcare provider if you have or have had any kidney or liver problems, including hepatitis virus infection.
- All the medicines you take, including prescription and over-the-counter medicines, antacids, laxatives, vitamins, and herbal supplements. BIKTARVY and other medicines may affect each other. Keep a list of all your medicines and show it to your healthcare provider and pharmacist, and ask if it is safe to take BIKTARVY with all of your other medicines.
- If you are pregnant or plan to become pregnant. It is not known if BIKTARVY can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking BIKTARVY.
- If you are breastfeeding or plan to breastfeed. Do not breastfeed. HIV-1 can be passed to the baby in breast milk.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1800FDA1088.
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Medications For Hiv Infection
Other names: Acquired Immune Deficiency Syndrome Acquired Immunodeficiency Syndrome Acute HIV Infection Acute Retroviral Syndrome AIDS AIDS-Related Complex ARC Chronic Symptomatic HIV Infection HIV HIV Infection, Acute HIV Seroconversion Syndrome HIV/AIDS Human Immunodeficiency Virus Infection Primary HIV Infection
HIV stands for human immunodeficiency virus. It is a virus that attacks the immune system, specifically CD4 cells , which eventually reduces a persons ability to fight infection. HIV can progress to AIDS if left untreated.
What Is Hiv Drug Resistance
When HIV isnât fully controlled by HIV medicine, the virus makes copies of itself at a rapid rate. As HIV multiplies in the body, it sometimes mutates and produces new forms of the virus that may not be as sensitive to a particular medicine as the original virus. This is called drug resistance.
With drug resistance, HIV medicines that previously controlled a personâs HIV are no longer effective against new, drug-resistant HIV. In other words, the HIV medicines can’t prevent the drug-resistant HIV from multiplying. Drug resistance can cause HIV treatment to fail.
A person can initially be infected with drug-resistant HIV or develop drug-resistant HIV after starting HIV medicines. Drug-resistant HIV also can spread from person to person. Drug-resistance testing identifies which, if any, HIV medicines wonât be effective against your specific strain of HIV. Drug-resistance testing results help determine which HIV medicines to include in an HIV treatment regimen.
Taking your HIV medicine as prescribed helps prevent drug resistance.
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Pretreatment Hiv Drug Resistance
Drug resistance can be found in some people before they begin treatment. This resistance can either be transmitted at the time of infection or acquired during previous treatments, for example in women given antiretroviral medicine to prevent mother-to-child transmission of HIV.
WHO recommends surveillance of HIV drug resistance in adults initiating or reinitiating ART and in treatment naive infants initiating ART to inform optimal selection of first-line regimens.
Up to 10% of adults starting HIV treatment can have drug resistance to the non-nucleoside reverse transcriptase inhibitors drug class. Pretreatment NNRTI resistance is up to 3 times more common in people with previous exposure to antiretroviral drugs. The prevalence of drug-resistant HIV is high in children under 18 months of age and newly diagnosed with HIV. Based on surveys conducted in 10 countries in sub-Saharan Africa , nearly one half of infants newly diagnosed with HIV have NNRTI resistant virus before initiating treatment.
The global prevalence of NNRTI resistance in adults and infants emphasizes the need to fast-track the transition to WHO-recommended dolutegravir-based treatments.
Pharmacologic Enhancers Or Drug Boosters
Ritonavir , taken in a low dose, increases blood levels of lopinavir and the drug LPV/r .
Cobicistat does the same thing in combination with atazanavir, darunavir,elvitegravir.
- Atazanavir + cobicistat, or ATV/c
- Darunavir + cobicistat, or DRV/c
- Elvitegravir + TDF + FTC + cobicistat, or EVG/c/TDF/FTC
- Elvitegravir + TAF + FTC + cobicistat, or EVG/c/TAF/FTC
Because these “drug boosters” can increase the levels of other drugs and cause potential harm, you should always tell your doctor about the medicines you are taking.
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Brief Guide To Antiviral Drugs
Violetta Shamilova, PharmD, is a board-licensed pharmacist. She is an assistant professor at the Touro College School of Health Sciences, and has worked at CVS pharmacy for five years. She completed the certified APhA Delivering Medication Therapy Management Services course.
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Viruses are intracellular parasites that co-opt cell machinery to reproduce. During reproduction, viruses destroy cells and go on to infect other cells.
During the 1950s, while researching possible treatments for cancer, scientists discovered chemical compounds that could inhibit viral DNA replication. During the 1980s and 1990s, after HIV became a problem, antiviral medications experienced a renaissance. Today, antiviral medications are used to treat many diseases.
In order to be effective, antiviral medications must target either viral entry or exit or screw with the virus while its inside a cell. Antiviral medications must also be specific so as not to cause systemic toxicity. Furthermore, antiviral drugs should be potent and stable.
Here are brief descriptions of some of the antiviral drugs currently available.
What Is An Entry Inhibitor
A monoclonal antibody called ibalizumab binds the CD4 molecule , which prevents viral entry into the cell. Medical professionals administer the drug as an intravenous infusion of 2,000 mg once, then two weeks later at 2,000 mg again, followed by 800 mg every two weeks. It is appropriate for heavily treatment-experienced patients with multidrug resistant virus who need new therapeutic options in order to achieve an undetectable viral load.
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How Is Hiv Treated
Although there is no cure for HIV, medications can dramatically slow the progression of the disease and people can live a relatively infection-free life. Few people die of AIDS these days thanks to effective treatments.Medications used to treat HIV are called antiretrovirals . Most people with HIV take combination ART every day. ART also reduces the risk of HIV transmission. Approved ARV treatments are grouped into seven drug classes as follows:
- Nucleoside reverse transcriptase inhibitors
- Non-nucleoside reverse transcriptase inhibitors
- Protease inhibitors
When To Start Hiv Treatment
Its now recommended that everyone diagnosed with HIV starts treatment straight away after being diagnosed.
In the UK, national guidelines set out standards for HIV treatment. They currently recommend that anyone with HIV who is ready to commit to treatment should start it regardless of their CD4 count .
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What Else Do I Need To Know About Taking Hiv/aids Medicines
It’s important to take your medicines every day, according to the instructions from your health care provider. If you miss doses or don’t follow a regular schedule, your treatment may not work, and the HIV virus may become resistant to the medicines.
HIV medicines can cause side effects. Most of these side effects are manageable, but a few can be serious. Tell your health care provider about any side effects that you are having. Don’t stop taking your medicine without first talking to your provider. He or she may give you tips on how to deal with the side effects. In some cases, your provider may decide to change your medicines.
Mode Of Action Protease Inhibitors
Protease Inhibitors are substrate analogues for the HIV aspartyl protease enzyme, which is involved in the processing of viral proteins. Once bound to the enzyme active site the enzyme is blocked from further activity. This inhibits the viral maturation process resulting in lack of functional virion formation.
These drugs are synergistic with reverse transcriptase inhibitors and are typically used in second line HAART treatment in South Africa.
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What Are Antiretrovirals And Why Do I Need Them
HIV damages your immune system by attacking blood cells that help fight infection. Acquired Immune Deficiency Syndrome is the condition that develops if HIV is not treated.
The medicines used to fight HIV are called antiretrovirals. They work to stop the virus multiplying. This helps protect your immune system from damage caused by HIV.
The medications used to treat HIV and AIDS may be similar.
If there is damage to your immune system, medicines can help stop further damage and even allow your immune system to partly repair itself.
Theres no cure for HIV and AIDS, but if youre careful to take your HIV medicines regularly, youre likely to live a long, healthy life, like most HIV-positive people in Australia.
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Why Is Hiv Treatment Important
If taken as prescribed, HIV medicine reduces the amount of HIV in your blood to a very low level, which keeps your immune system working and prevents illness. This is called viral suppression, defined as having less than 200 copies of HIV per milliliter of blood.
HIV medicine can also make your viral load so low that a standard lab test canât detect it. This is called having an undetectable level viral load. Almost everyone who takes HIV medicine as prescribed can achieve an undetectable viral load, usually within 6 months after starting treatment. Many will bring their viral load to an undetectable level quickly, but it could take more time for a small portion of people just starting HIV medicine.
There are important health benefits to getting the viral load as low as possible. People with HIV who know their status, take HIV medicine as prescribed, and get and keep an undetectable viral load can live long and healthy lives.
There is also a major prevention benefit. People with HIV who take HIV medicine as prescribed and get and keep an undetectable viral load will not transmit HIV to their HIV-negative partners through sex. Learn more about the prevention benefits of having an undetectable viral load.
HIV treatment is most likely to be successful when you know what to expect and are committed to taking your medicines exactly as prescribed. Working with your health care provider to develop a treatment plan will help you learn more about HIV and manage it effectively.
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What Are The Benefits Of Antiviral Drugs
When treatment is started within two days of becoming sick with flu symptoms, antiviral drugs can lessen fever and flu symptoms and shorten the time you are sick by about one day. They also may reduce the risk of complications such as ear infections in children, respiratory complications requiring antibiotics, and hospitalization in adults. For people at higher risk of serious flu complications, early treatment with an antiviral drug can mean having milder illness instead of more severe illness that might require a hospital stay. For adults hospitalized with flu illness, some studies have reported that early antiviral treatment can reduce their risk of death.
Hiv Treatment Options: Hiv Medications And Drug Classes
The following tables list the main classes and groups of FDA-approved medications used to treat HIV in the U.S., with a brief description of the drug class. New options are frequently approved.
Drugs and combinations are identified by generic and brand names, as well as common abbreviations.
Follow the links to access up-to-date drug information such as dosing, side effects, drug interactions and pill pictures for each agent and drug class.
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What Is Hiv Treatment
HIV treatment involves taking highly effective medicines called antiretroviral therapy that work to control the virus. ART is recommended for everyone with HIV, and people with HIV should start ART as soon as possible after diagnosis, even on that same day.
People on ART take a combination of HIV medicines called an HIV treatment regimen. A person’s initial HIV treatment regimen generally includes three HIV medicines from at least two different HIV drug classes that must be taken exactly as prescribed. There are several options that have two or three different HIV medicines combined into a once-daily pill. Long-acting injections of HIV medicine, given every two months, are also available if your health care provider determines that you meet certain requirements.